Chapter 16 Anti-aging, Cancer, Preventative Medicine

1. Chapter 16Anti-aging, Cancer, Preventative Medicine

2. Four Stages of Adulthood • Ages 19-30 (young adulthood) • Ages 31-50 (young adulthood) • Ages 51-70 (middle-age adulthood) • Ages 70 and up (older adulthood) • Nutritional needs change • Lifestyle and nutrition play important roles

3. Diet for Younger Adults • Emphasis on plant/ whole grain products • Moderate intake of cured and smoked foods • Adequate fluoride • Plenty of fluids • Iron-rich foods for women • Folate concerns for women • Calcium and vitamin B-12 concerns for vegans

4. How Are We Doing – the U.S. since 1950s? • Eating less saturated fat • Eating more cheese . . .sat fat. • Eating less animal fat and more vegetable oils • Leaner cattle and hogs available (farmers) • High intakes of white bread, beef, chicken, milk, donuts, cakes, cookies, soft drinks, mayonnaise, sugar/sweets

5. Life Span • Maximum number of years a human can live • Record • 122 years (woman) • 114 years (man) • Dependent on genes and environment

6. Life Expectancy • Number of years an average person, born in a specific year, is expected to live • In North America: • 75 yrs for men • 80 yrs for women • Only 64 “healthy years” • Anticipate a tremendous growth in the 85+ years old population by 2020

7. Graying of America • People over 65: • Account for 13% of the US population • Account for ~25% of all prescription medication • Account for 40% of all hospitalizations • Account for 50% of federal health budget • 65% have nutrition-related problems

8. What is Aging? • “Process of slow cell death” • Cells age and die • Aging body can no longer replenish cells or meet physiological demands • Organs retain reserve capacity • Maintain normal function with decreased cell number or activity for a while • After reserve capacity is exhausted, function decreases

9. Challenge Question • What is the reserve capacity of an organ? What happens when the bodies reserve capacity of certain organ cells starts depleting?

10. Decline of Physiological Function

11. What Causes Aging? Mutagens, Pesticides, too much SUN! Free radicals, Oxygen Reduce Quantity of Calories!

12. Resveratrol and Anti Aging • SIRt -1 Activator – • Mimics Calorie Restriction (CR) diet effect • Increases mitochondria turnover • Replaces worn out mitochondria • (less free radical production, cell damage) • Forms New Mitochondria - more efficient • Higher E returns . . More ATP, less free radicals . . ? resveratrol http://www.youtube.com/watch?v=R3TGKOQeTrc&NR=1&feature=fvwp

13. Fountain of Youth? • National Institute on Aging www.nia.nih.gov • Free fact sheet • Diet and lifestyle practices to minimize decline • Avoid excessive sun exposure • Avoid exposure to environmental hazards and chemicals (herbicides, toxins, oil, carcinogens) • Healthy diet; low calorie diet? • Why Vegos live longer. . .

14. Alternative Medicine • Not evaluated by FDA • Questionable purity and quantity • Possible health risks • Use only one product at a time • Keep a diary of symptoms • Check with physician before discontinuing prescribed medication

15. Alternative Medicine tannins

17. Alternative Medicine – See class website BREAK • Alternative Medicine Foundation www.amfoundation.org • NCCAM Complementary and Alternative Medicine Citation Index nccam.nih.gov/ • American Botanical Council abc.herbalgram.org • Complementary and Alternative Medicine Program at Stanford camps.stanford.edu/ • National Institutes of Health Office of Dietary Supplements ods.od.nih.gov/ • Natural Medicine Comprehensive Database www.naturaldatabase.com

18. Alcohol Absorption • Absorbed rapidly via simple diffusion • Not digested really • Depends on rate of stomach emptying • Rate of absorption • Wine  liqueur  beer (slowest) • Alcohol is found wherever water is found in the body • Easily moves through the cell membrane (damaging it)

20. Alcohol (Ethanol) Metabolism • Depends on • Gender, race, size, food, physical condition, alcohol content • Women metabolize Alcohol differently! • Less metabolism using stomach cells • Less water in body to dilute effects • Majority is metabolized by the liver • Alcohol cannot be stored • Alcohol has priority in metabolism • Vs protein, carbohydrate, fat (i.e. stored)

21. One drink: 12 oz beer or wine cooler 5 oz wine 3 oz sherry or liqueur 1.5 oz 80-proof distilled spirits Decrease risk for cardiovascular disease Socialization Benefits of Moderate Alcohol Consumption

22. Alcohol Abuse • Contributes to 5 of 10 leading causes of death • When combined with tobacco • Increases the risk for esophageal and oral cancer • Increased risk for: • Heart damage, arrhythmia, hypertension, stroke, osteoporosis, brain damage, colorectal cancer, breast cancer, nutritional deficiencies, fetal damage, obesity, impotence, sleep disturbances, infections, hypoglycemia

23. Cirrhosis • Fatty infiltration of the liver • Increased synthesis of fat • Enlarged fat cells • Choke off nutrient and O2 supply to liver cells • Engorged fat cells burst and die • Scar tissues • 50% chance of death within 4 years • Advanced stages are not reversible • Destruction of vital tissues regardless of diet • Transplant is common

24. Alcohol Dependence • Most common psychiatric disorder • Affects 13% of North Americans • Addictive and dangerous (loss of 10 years of life???) • Genetic influence • Tolerance to alcohol • Be aware of alcohol consumption • Children of alcoholics are 4x more likely to become alcoholics themselves • Warn children of alcoholic families of the dangers by age 10 • Long-term drinking poses risk for all • Drinking increasing quantities

25. Diagnosis • Physiological dependence on alcohol • Tolerance to the effects of alcohol • Alcohol-associated illnesses (memory loss, liver disease, etc.) • Continued drinking in defiance of medical and social contraindications • Depression and blackouts • Flushed face/reddened skin

26. CAGE Screening • C: Have you every felt you ought to cut down on drinking? • A: Have people annoyed you by criticizing your drinking? • G: Have you ever felt bad or guilty about your drinking? • E: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover? (As an eye-opener)

27. Treatment • Guidance from a physician (blood work?) • Liver enzymes (AST and ALT) elevated? • Counseling • Total abstinence • AA 12-step program • Treatment programs • Medication (blocks craving or causes physical reaction when drinking)

28. Guidance Regarding Alcohol • Dietary Guidelines for Americans • Moderation (1/day ~ Women, 2/day ~ Men) • Lower risk for CVD • Little benefits for younger people • Drink with meals • Don’t drink and drive • Avoid drinking while pregnant

29. Nutrition and Cancer • Genetic predispositions (colon, breast, prostate) • 30 cancer susceptibility genes identified • Diet ~ likely to account ≥30-40% all cancers • ONLY 1-5% cancers explained via inherited genes? • Little control/ genetic risks, • Much control over environmental/physical/diet • e.g. smoking, physical activity, nutrient intake • Some foods/ additives contribute to CANCER: • Nuts, peanut butter (aflatoxin) • Nitrosamines (smoked meats) (aflatoxin

30. Confirming your Knowledge • What % of cancers in the US are due to tobacco use? • What % of Cancers of the Mouth, pharynx and larynx are associated with excess alcohol use? What is the main “diet” cancer risk factor? What is the recommended % Calories from Fat suggested by the N.C.I.? to reduce cancer risk? What about if you are at risk genetically for cancer?

31. Nutrition and Cancer

32. Nutrition and CancerChallenge Question • Antioxidants: potent anti-cancer compounds • What are good vitamin examples that combat the formation of free radicals  cancer? • What are some good sources of each

33. Di Indole Methane lycopene AVOID- Charred

34. Warning Signs of Cancer • Change in bowel or bladder habits • Sore that won’t heal • Unusual bleeding/ discharge • Thickening lump in breast or elsewhere • Ingestion/difficulty swallowing • Obvious change in Wart or mole. . • Nagging cough or hoarseness • Unexplained weight loss. .

35. Medical testing for Cancer • Colonoscopy exams (middle age/older) • Prostate Specific Antigen (PSA) • Papanicolaou tests (Pap smears) • Regular breast exams (Momograms >40 years) • Biopsy or Blood work if suspect something abnormal! • - Don’t delay!!! • Early Detection is Critical for successful treatment. . .

36. The Bottom Line – Reducing Cancer Risk Di Indole Methane • Diet Moderate Calories, Low Fat Content • Many Veggies, fruits, Whole Grains, • Low fat dairy, cereals, breads, fish • Alcohol moderation: 1/day Women, 2/day men • Limit animal fat, salt, smoked, nitrate cured meat • Avoid exposure to environmental toxins • Pesticides, mutagens etc. (go organic) • If left untreated can spread (metastisis) • EARLY Detection is Critical!!! for successful treatment • Get Simple blood tests or Biopsy –DON”T DELAY • Be Salubrious!!! ~ Live Long & Prosper!!!

37. Search Engines - Biomedical Research • Questions about Diet, Nutrition and Supplements??? • Sci-finder Scholar: TUTORIAL (MOST POWERFUL Scientific literature Database) • See website: Nutrition questions? e.g. • Hydroxycut and liver toxicity? • Creatine and Kidney failure? • Caffeine and Pregnancy risk? • Others?

38. Course Instructor/ TA evaluationsneed student volunteer • TA Qs • 1. Was the grading for the class assignments fair? • 2. Were the assignments turned back in a reasonable amount of time? • 3. Where your exams graded fairly and turned back in a reasonable amount of time? • 4. Were the exam questions fair and did they allow you to demonstrate your knowledge from subject matter covered in this course?

39. Benefits of Good Nutrition& longevity • Delays onset of some diseases • Improves current condition • Improves quality of life • Decreases length of hospital stay